Paediatric nephrology in under-resourced areas

Background Nearly 50% of the world population and 60% of children aged 0 to 14 years live in low- or lower-middle–income countries. Paediatric nephrology (PN) in these countries is not a priority for allocation of limited health resources. This article explores advancements made and persisting limit...

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Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 2022-05, Vol.37 (5), p.959-972
Main Authors: Banerjee, Sushmita, Kamath, Nivedita, Antwi, Sampson, Bonilla-Felix, Melvin
Format: Article
Language:English
Subjects:
Analysis
Child
Children
Costs and Cost Analysis
Electron microscopy
Epidemiology
Fluoroscopy
Health care rationing
Humans
Immunofluorescence
Income
Medicine
Medicine & Public Health
Methods
Nephrology
Pediatrics
Renal Replacement Therapy
Review
Services
Urology
Workforce
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Summary:Background Nearly 50% of the world population and 60% of children aged 0 to 14 years live in low- or lower-middle–income countries. Paediatric nephrology (PN) in these countries is not a priority for allocation of limited health resources. This article explores advancements made and persisting limitations in providing optimal PN services to children in such under-resourced areas (URA). Methods Medline, PubMed and Google Scholar online databases were searched for articles pertaining to PN disease epidemiology, outcome, availability of services and infrastructure in URA. The ISN and IPNA offices were contacted for data, and two online questionnaire surveys of IPNA membership performed. Regional IPNA members were contacted for further detailed information. Results There is a scarcity of published data from URA; where available, prevalence of PN diseases, managements and outcomes are often reported to be different from high income regions. Deficiencies in human resources, fluoroscopy, nuclear imaging, immunofluorescence, electron microscopy and genetic studies were identified. Several drugs and maintenance kidney replacement therapy are inaccessible to the majority of patients. Despite these issues, regional efforts with support from international bodies have led to significant advances in PN services and infrastructure in many URA. Conclusions Equitable distribution and affordability of PN services remain major challenges in URA. The drive towards acquisition of regional data, advocacy to local government and non-government agencies and partnership with international support bodies needs to be continued. The aim is to optimise and achieve global parity in PN training, investigations and treatments, initially focusing on preventable and reversible conditions.
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-021-05059-y